Misrepresentation of stem-cell science in Italy by political and religious groups is damaging that nation's laws and the funding and perceived value of biomedical research, argues Elena Cattaneo.
Staminalia: Le Cellule Etiche e i Nemici Della Ricerca
- Armando Massarenti
On 1 April 2004, Elizabeth Blackburn, co-discoverer of the telomerase enzyme, published an article in the New England Journal of Medicine entitled 'Bioethics and the political distortion of biomedicine'. In it she reported her experience of working on, and being suddenly fired from, the US President's Council on Bioethics as it drew up its report on monitoring stem-cell research. Blackburn suggests that she was removed because her evidence-based views were not politically acceptable.
Sadly, similar cases have become common in Italy in the past two decades, particularly in the arena of stem-cell research, as Armando Massarenti explains in Staminalia: Le Cellule Etiche e i Nemici Della Ricerca (Staminalia: Ethical Cells and the Enemies Of Research). Massarenti, a science philosopher who writes for the Italian newspaper Il Sole 24 Ore, describes the political and bioethical disputes under way in Italy, highlighting the contradictions in how research carried out on stem cells derived from early human embryos (blastocysts) compares with studies on stem cells from adult tissues. He reveals the existence of a strategy to generate confusion between the scientific, ethical, religious and political aspects of stem-cell work.
Stem-cell research has evolved rapidly, from James Thomson's first isolation of human embryonic stem cells in 1998 to Shinya Yamanaka's recent discovery of cellular reprogramming. As the field has developed, researchers have held vigorous discussions about the validity and repeatability of results. In parallel, a debate has broken out on the morality of experimenting with early human embryos or their stem-cell derivatives, as some religions or moral philosophies consider human embryos consisting of more than 100 cells to be ontologically and symbolically equivalent to a human.
Most countries have avoided misinterpretation of the results and uncertainties of stem-cell research for political purposes. But in Italy manipulation has been widespread, the book reports. Indeed, some members of the Catholic church hierarchies still claim that research on embryonic stem cells is unnecessary. As Staminalia describes, Yamanaka and colleagues noted the continued need for embryonic stem-cell research in a 2007 letter in Cell Stem Cell about the discovery of induced pluripotent stem cells from adult tissues; yet the religious media reported the opposite. Other parts of the Catholic political milieu have incorrectly stated that scientists working on embryonic stem cells in Italy are acting against the law. And I have myself been depicted in the media as a bad scientist and teacher and worse, following my organization of an open workshop on embryonic stem cells.
Such distortions coloured the law on in vitro fertilization passed by the Italian parliament in 2004. It made it illegal to derive embryonic stem cells from supernumerary frozen blastocysts, and the political process itself stirred up wider opposition to stem-cell research. With few exceptions, the majority of Italian biomedical scientists protested against the law in a subsequent referendum campaign. They objected to the misuse of science to sustain a controversial ethical debate with consequences for research freedom, including the risk of reducing opportunities to learn about early-derived embryonic stem cells and their developmental potential. The protest did not stop religious hierarchies and political parties from continuing their campaign. Despite a 2006 Eurobarometer survey that showed more than 60% of Italians approved of embryonic stem-cell research, the referendum failed to overturn the law. Massarenti reminds us that the media also played a role in conveying the incorrect view of a split scientific community, as if scientists debated the ideological issues in the same way as did the political and religious personalities.
Similar attitudes have prevailed in the United States under President George W. Bush. There, a presidential decree prohibits the public financing of embryonic stem-cell research — but this is camouflage. By allowing private funding of the same research to continue, the government can pretend to ban something yet still take advantage of it. In Italy and the United States, politicians are allowing religious ideas to influence the rules of a state and opposing science without clarifying the consequences to the citizens who have elected those politicians.
The book then comes to its most crucial point. Those opposed to embryonic stem-cell research in Italy and elsewhere are not simply presenting their ethical or religious arguments and asking those who share them to adopt a consistent behaviour. Rather, they are denigrating scientific results by emphasizing disagreements and spreading false information about the alleged scientific or therapeutic superiority of the research that they wish to support. This approach is applied to stem-cell research today, but tomorrow could be directed at any other field of science judged to be troublesome.
Misinformation has consequences for the political guidelines that sustain research. In countries where funding allocations are based on peer review, these effects should be containable. Competition for the best ideas will not depend on a scientist's political or religious points of view or public perception. Where conflicts of interest pollute the management and public funding of science, as in Italy, misinformation may inspire and strengthen political interference with devastating effect, beyond damaging the research that could otherwise enhance the cultural and economic contribution of a country rich in creativity.
Where a peer-review culture is lacking, a country will not benefit from open competition for the best ideas. Negotiation between the public administration and research institutions will lead to an allocation of funds without a transparent evaluation system. Committees will finance their own members, and financial acts could assign millions of euros of public money every year to favoured institutions, according to the biases of ministers.
Such a background of patronage is fostering the political distortion of biomedical research and undermining the autonomy of science in Italy, in my view. Factors leading to the manipulation and censoring of Italian science, particularly stem-cell research and plant biotechnologies, should be analysed thoroughly. This would educate the public in the ethics of science and prevent similar situations from arising in other countries.
Italy does have excellent scientists who understand the basic concept of peer review. What is missing is ethical public-asset management. As Massarenti explains, many researchers find it difficult to accept that it is impossible to support and invest in science effectively if conflicts of interest are not eliminated. Other countries have recognized this. In 1986 Spain created the ANEP, a national evaluation and foresight agency that is charged with selecting the best projects on behalf of ministers, regions and even private foundations. I hope that a similar mechanism will be adopted in Italy for public funding of biomedical research. The Italian government is moving in the right direction, through propositions from some of its past and current members. But a reliable peer-review system requires two things: the removal of conflicts of interest and of the suspicion that decisions may be influenced by personal interests.
The ethical dimension of science is at the core of Staminalia. Science's objectivity has been appreciated since Galileo Galilei, even though for a long time it was judged as a heresy. Yet, many principles of democratic coexistence have been built on this ethical dimension. The possibility of criticizing and reviewing results is an essential part of science and of the moral and civil growth of a nation. Those attacking these values and representing science and scientists as a threat to humanity are expressing intolerance and contempt for democracy itself.
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